REVIEWS OF BOOKS.
A Manual of Modern Surgery, General and Operative. By John Chalmers Da Costa, M.D., Demonstrator of Surgery, Jefferson Medical College; Chief Assistant Surgeon, Jefferson Medical College Hospital, etc. Small 8vo, pp. 809. Philadelphia : W. B. Saunders, 1894.
This is a very attractive little book. It is hardly more than one-third the size of the American Text-Book, and about one-sixth the size of Agnew’s Surgery, but it is proportionately larger than the little remembrancers and outlines of the subject by still other authors. By excluding obsolete and unessential methods, and omitting any attempt to exploit fanciful theories or indefensible hypotheses, the author has sought to attain the happy medium between prolixity and meagreness. Whether or not he has succeeded in his effort, each reader must judge for himself in the light of his own necessities. He certainly has produced a very clear and concise treatise in a very charming style.
The apology which he makes for opening the book with a section on bacteriology is entirely superfluous. In the present state of medical science an acquaintance with bacteriology is an absolute essential to a proper comprehension of surgical pathology. Dr. Da Costa’s brief article on the subject is noticeable for its clearness,—the most dense of readers could not fail to understand it at once.
It is not so easy to understand, however, why he should have relegated his short section on Asepsis and Antisepsis to the end of the book. A chapter treating of facts, upon which the entire superstructure of modern operative work is founded, would logically have preceded the consideration of all operative procedures. The section in itself is excellent, notwithstanding its anomalous position, tersely discussing the applicability of aseptic and antiseptic precautions, outlining the preparations for operation, and considering the various operative materials.
About one-fourth of the book is occupied with fractures and dislocations. He quite properly ignores the treatment of fractures involving the elbow-joint with the forearm extended, advising immobilization with the joint at the right angle. He does not recognize the importance of the periosteal pseudo-ligament in the pathology of Colles’ fracture, and he recommends the Bond splint for its treatment; the statement at the end of the section that “some surgeons dress Colies’s fracture with a band of adhesive plaster around the wrist, and support the extremity in a sling” is an encouraging gleam of light, however.
Among the operative sections of the work, that devoted to Diseases and Injuries of the Head is particularly noticeable on account of its up-to-date character. The instruction in methods of cerebral localization is clear and definite, and the scope of his remarks on cranial surgery is comprehensive; intracranial tumors and the operative treatment of epilepsy receive careful consideration.
His statement in connection with intestinal obstruction, that “puncture of the intestine with an aseptic hypodermatic needle introduced obliquely will relieve gaseous distention,” will hardly stand the test of practical application. His teachings on abdominal surgery in general are good, however, and present the latest accepted views on the subject.
A detailed examination of the entire work only confirms the favorable impression given at first sight, and Dr. Da Costa is to be congratulated upon having produced a work of distinct surgical utility.
The publisher’s work has been done nearly as well as that of the author, for the mechanical execution is excellent, although the binding is a little too light for the size of the book; the type is large and clear, the paper is excellent, and the illustrations are well chosen. But the index is difficult to find, on account of the presence at the back of the book of a catalogue of the works issued by the publisher, printed on the same paper as the body of the book. Far from being objectionable in itself the catalogue may often be very useful in rendering easily accessible a list of the other publications of the publisher of this work, but it should have been so arranged as not to interfere with the readiness with which the index can be consulted. There are several ways in which this might be accomplished, the most effective, perhaps, being the use for the catalogue of colored paper.
James E. Pilcher.
The Proceedings of the Fourth Annual Meeting of the Association of Military Surgeons of the United States. 8vo, 800 pages; illustrated. St. Louis : Buxton & Skinner Stationery Co., 1894.
The fact that this large volume represents the work accomplished at a single annual meeting argues well for the activity of the Association of Military Surgeons. It will doubtless be a matter of surprise to many members of the medical profession that “in these piping times of peace” this especial department of medicine should be the scene of so much virile activity; they will be interested too, for most of the papers here collated are valuable to students of history, of law, of mechanics, and even to the casual reader. All branches of the military service are represented, and the National Guard divides the honors with the “Regulars.”
The first eighty pages are devoted to the secretary’s report of the meeting held at Washington on the 1st, 2d, and 3d of May, 1894. Reports of committees, the discussion of the papers read, lists of officers, committees, and members, and the constitution and by-laws of the Association are included, so that the reader is able to form an excellent idea of the aims of the organization, and also of the members themselves.
Nearly two score of articles are published; the standard of excellence is high, and most of the articles bear witness to extensive research and practical experience. The topics range from surgical techniques to military logistics, reflecting the broad scope of medical practice in a military context.
Key Takeaways
- Dr. Da Costa's manual provides clear and concise surgical guidance, avoiding outdated methods and unproven theories.
- The importance of bacteriology in understanding surgical pathology is emphasized.
- Asepsis and antisepsis are crucial for modern operative procedures but are discussed later in the book than expected.
Practical Tips
- When treating fractures, ensure proper immobilization techniques to prevent further injury.
- Use adhesive plaster around the wrist and support the extremity in a sling for Colles' fracture treatment.
- For abdominal surgery, follow the latest accepted views on the subject as outlined by Dr. Da Costa.
Warnings & Risks
- Avoid puncturing the intestine with an aseptic hypodermatic needle to relieve gaseous distention; this method is not practical.
- Be cautious about the placement of sections in medical texts, as critical information like asepsis and antisepsis may be misplaced.
Modern Application
While much has changed since 1894, understanding historical surgical practices provides valuable context for modern emergency medicine. Techniques such as proper immobilization for fractures and the importance of bacteriology remain relevant today.
Frequently Asked Questions
Q: What is the significance of Dr. Da Costa's approach to excluding outdated methods in his manual?
Dr. Da Costa’s exclusion of obsolete and unessential methods ensures that readers are not misled by outdated practices, focusing instead on current and effective surgical techniques.
Q: Why does the reviewer suggest moving the section on asepsis and antisepsis to an earlier part of the book?
The reviewer believes that a chapter on asepsis and antisepsis should precede operative procedures because these principles form the foundation for modern surgical practices.
Q: What is the recommended treatment for Colles' fracture according to Dr. Da Costa's manual?
Dr. Da Costa recommends immobilization with the joint at a right angle and uses the Bond splint, but also notes that some surgeons use adhesive plaster around the wrist and support in a sling.